Author Type of study Sample size (implants) Detoxification
method 		Bone substitute/membrane Antimicrobial Follow-up
(months) 		PD
Mean (SD) mm 		BOP+ Mean, % Radiologic bone level
Mean (SD) mm 		Complications Comments Submerge
IN ΔPD IN ΔBOP IN ΔRBL
Deppe et al. [22] Prospective clinical study 19 (6 patients)a No augmentation 20 - 236 5.1 (1.3) 0.8 (1.2) No data No data 7.6 (1.4) 0.3 (1.3) 8 implants were lost in augmented bone groups due to infection and 5 implants lost in non-augmented sites. With the respect to the long term results of augmentation procedures, the method used for decontamination seems to play a subordinate role. Augmentation with 1:1 mix of AB and βTCP can lead to reduction of the defect depth. Y
15 (7 patients) AB mixed with βTCP 1:1/PTFE 4.8 (1.4) 2.3 (1.2) 6.8 (1.2) 2.1 (1.1)
22 (10 patients)a CO2 laser No augmentation 6.1 (1.6) 2.7 (1.5) 7.2 (1.3) 0.4 (1.1)
17 (9 patients) AB mixed with βTCP 1:1/PTFE 5 (1.3) 2.5 (1.3) 6.7 (1.5) 2.2 (1.3)
Roos-Jansåker et al. [23] Prospective clinical study 29 (17 patients) 3% H2O2, Saline FHA/SRM 0.1% CHX rinse for 5 weeks.
Amx (375 mg x 3) + Metro (400 mg x 2) for 10 days. 		12 5.4 (1.8) 2.9 (1) 79.3% 57.7% 3.4 (1.2) 1.5 (1.2) Membrane exposure after 2 weeks was noted in 43.8% of the treated implants. It is possible to treat peri-implant defects with a bone substitute, with or without a resorbable membrane. N
36 (19 patients) FHA 5.6 (1.8) 3.4 (1.7) 92.9% 67.9% 2.8 (0.8) 1.4 (1.3) Uneventful
Roos-Jansåker et al. [24] Case series 16 (12 patients) 3% H2O2, Saline FHA/SRM 0.1% CHX rinse for 5 weeks.
Amx (375 mg x 3) + Metro (400 mg x 2) for 10 days. 		12 5.1 (1) 4.2 (1.5) 75% 62.5% 3.8 (1) 2.3 (1.2) 62.5% implant sites demonstrated inadequate primary healing with the presence of soft tissue craters.
Membrane exposure 75.1% 		Treatment of peri-implantitis defect using a bone graft substitute combined with a resorbable membrane and submerged healing resulted in defect fill and clinical healthier situations. Y
Schwarz et al. [25] Case series 11 (11 patients) Saline nanoHA 0.2% CHX rinse for 2 weeks. 24 6.9 (0.6) 1.5 (0.6) 80%; 36% No data Suppuration around 2 implants Both treatment procedures have shown efficacy, however, the application of natural bone mineral in combination with a collagen membrane may result in an improved outcome of healing. N
11 (11 patients) BDX/CM 7.1 (0.8) 2.4 (0.8) 78% 44% N
Romanos et al. [26] Case series 19 (15 patients) CO2 laser AB or BDX/CM 27 6 (2) 3.5 (1.3) No data No data No data Bovine xenograft provided more radiographic bone fill than autogenous graft, because of autogenous graft resorption over time. YN
Schwarz et al. [27] Case series 9 (9 patients) Saline nanoHA 0.2% CHX rinse for 2 weeks. 48 6.9 (0.6) 1.1 (0.3) 80% 32% Decreased translucency in the former peri-implant defect area noticed at 8 sites in nanoHA and 5 sites in BDX/resorbable membrane group. Uneventful While the application of natural bone mineral with a collagen membrane resulted in clinical improvements, a long-term outcome obtained with nanocrystaline hydroxyapatite without a barrier membrane must be considered as poor. N
10 (10 patients) BDX/CM 7.1 (0.7) 2.5 (0.9) 79% 51% N
Schwarz et al. [28] Prospective clinical study 9 (9 patients) Saline DBX/CM 0.2% CHX rinse for 2 weeks. 12 6.7 (0.7) 1.6 (0.9 81.5% 38.9% No data Uneventful Defect configuration may have an impact on the clinical outcome following surgical regenerative therapy of peri-implantitis lesions. N
9 (9 patients) 7.1 (0.6) 1.6 (0.7) 83.3% 25.9%
9 (9 patients) 7 (0.5) 2.7 (0.7) 85.2% 61.1%
Roccuzzo et al. [29] Prospective clinical study 14 TPS implants (14 patients) 24% EDTA gel, 1% CHX gel. Saline BDX Axm and Clavulanic acid (1000 mg x 2) for 6 days.
0.2% CHX rinse for 3 weeks. 		12 7.2 (1.5) 2.1 (1.2) 91.1% 33.9% 3.9 (1.6) 1.6 (0.7) No complications Clinical parameters around moderately rough implants were better than around rough implants.
Surgical regenerative technique described resulted in a clinical healthier situation around many of the treated implants so that their function could be fully maintained. Complete fill of the bony defect seems not to be a predictable result. 		N
12 SLA implants (12 patients) 6.8 (1.2) 3.4 (1.7) 75% 60.4% 3 (0.9) 1.9 (1.3)
Froum et al. [30] Case series 19 (15 patients) AA, Saline, Tetracycline (50 mg/mL), 0.12% CHX DBX or MBA/Enamel matrix derivative/ /PDGF/CM or SCTG Amx 500 mg x 3 for 10 days.
0.12% CHX rinse for 2 weeks. 		36 - 90 8.8 (1.9) 5.4 (1.5) 100% 78.9% 6.4 (1.9) 3.8 (1.5) Regenerative approach for the treatment of peri-implantitis appear to be encouraging. N
Aghazadeh et al. [31] Randomized controlled clinical study 34 (22 patients) 3% H2O2, Saline AB/resorbable bovine collagen Azithromycin (250 mg x1) for 4 days.
0.1% CHX rinse for 6 weeks. 		12 6 (1.3) 2 (1.2) 87.5% 44.8% 5.8 (1.7) 0.2 (1.8) BDX provided more radiographic bone fill than AB. The success for both surgical regenerative procedures was limited. N
37 (23 patients) BDX/resorbable bovine collagen 6.2 (1.4) 3.1 (1.2) 79.4% 50.4% 5.2 (1.8) 1.1 (1.9)
Wohlfahrt et al. [32] Randomized clinical trial 16 (16 patients) 24% EDTA gel. Saline Porous titanium granules 0.2% CHX rinse for 4 weeks.
Amx (500 mg x 3) + Metro (400 mg x 2) for 10 days. 		12 6.5 (1.9) 1.7 (1.7) No data No data 6.8 (2.7) 2 (1.7) Uneventful Reconstruction with porous titanium granules resulted in significantly better radiographic peri-implant defect fill compared with controls. Y
16 (16 patients)a No augmentation 6.5 (2.3) 2 (2.3) No data No data 6.8 (3.9) 0.1 (1.9)
Wiltfang et al. [33] Case series 36 (22 patients) Implantoplsty, 20% Phosphoric Acid AB mixed with BDX 1:1 Ampicillin/sulbactam 1500 mg preoperatively. 12 7.5 (1.8) 4 (1.8) 61% 36% 5.1 (2.4) 3.5 (2.4) One local infection 1 week after surgery causing loss of the augmentation material without loss of the implant. Surgical regenerative treatment provided a reliable method to reduce peri-implantitis induced bone defects. N
Schwarz et al. [34] Prospective clinical study 7 (7 patients) Implantoplasty, Saline BDX/CM Non specified antibiotic medication for 5 days. 48 5.5 (1.7) 1.2 (1.9) 100% 85.2% No data Reinfection in 4 patients occurred between 24 - 36 months postoperatively. A combined surgical respective/regenerative therapy of peri-implantitis were not influenced by the method of surface decontamination. N
10 (10 patients) Implantoplasty,
Er:YAG laser 		5.1 (1.5) 1.3 (1.8) 95.2% 71.6%
Matarasso et al. [35] Case series 11 (11 patients) Implantoplasty,
AA, Saline 		DBX/CM Amx 875 mg and clavulanic acid 125 mg x 2 for 5 days.
0.12% CHX rinse for 4 weeks. 		12 8.1 (1.8) 4.1 (1.5) 19.7% 13.6% 8 (3.7) 2.7 (3.3) Membrane exposure in 18% of cases. Combined regenerative/resective surgical approach for the treatment of peri-implantitis defects yielded positive clinical and radiographic results after 12 months. N
Roos-Jansåker et al. [36] Prospective clinical study 23 (13 patients) 3% H2O2, Saline FHA/SRM 0.1% CHX rinse for 5 weeks.
Amx (375 mg x 3) + Metro (400 mg x 2) for 10 days. 		60 5.6 (1.9) 3 (2.4) 75% 42.4% 4.6 (1.3) 1.5 (1.2) Membrane exposure The use of a resorbable membrane in combination with a bone substitute did not add to the predictability or extent of bone fill. N
22 (12 patients) FHA 6 (2.2) 3.3 (2) 94.3% 82.9% 4 (0.8) 1.1 (1.2)
Jepsen et al. [37] Randomized clinical trial 33 (33 patients) Titanium brush, 3% H2O2, Saline Porous titanium granules 0.2% CHX rinse for 4 weeks.
Amx (500 mg x 3) + Metro (400 mg x 2) for 8 days. 		12 6.3 (1.3) 2.8 (1.3) 89.4% 56.1% 4.6 (2) 3.6 (2) Uneventful Reconstructive surgery using porous titanium granules resulted in significantly enhanced radiographic defect fill compared with open flap debridement. The radiographic findings must be interpreted with caution, because it is difficult to discern biomaterial and newly formed osseous tissue. N
30 (30 patients)a No augmentation 6.3 (1.6) 2.6 (1.4) 85.8% 44.9% 4 (2.5) 1.1 (1.4)
Froum et al. [38] Prospective clinical study 168 (100 patients) AA, Saline, Tetracycline (50 mg/mL), 0.12% CHX DBX or MBA/Enamel matrix derivative/ /PDGF/CM or SCTG 24 - 120 8.1 (2.5) 5.1 (2.2) 100% 91.1% 3.8 (2.3) 1.8 (2) 2 implants were lost at 6 months follow up 16.7% of cases needed additional surgeries to obtain desired result. Regenerative protocol used in treating peri-implantitis produced positive clinical outcomes in terms of reduction in BOP and PD, bone gain, and implant survival. N
Roccuzzo et al. [39] Prospective clinical study 71 (71 patients) Titanium brush, 24% EDTA gel, 1% CHX gel. Saline DBX Axm and Clavulanic acid (1000 mg x 2) for 6 days.
0.2% CHX rinse for 3 weeks. 		12 7.2 (1.6) 2.9 (1.7) 71.5% 53.2% No data No data 6 implants were explanted due to persistent pus formation after 12 months. Partial defect fill was obtained. Complete resolution does not seem a predictable outcome. N

aNon augmented control groups were excluded for evaluation.
NanoHA = nanocrystalline hydroxyapatite; BDX = bovine-derived xenograft; CHX = chlorhexidine solution; Saline = Sterile physiologic saline solution; FHA = fluorohydroxyapatite, Amx = Amoxicillin; Metro = Metronidazole; AB = autogenous bone; SCTG = Subepithelial connective tissue graft; PDGF = Platelet-derived growth factor; MBA = mineralized bone allograft; βTCP = beta tricalcium phosphate; CM = collagen membrane; PTFE = polytetrafluoroethylene membrane; SRM = synthetic resorbable membrane; AA = air abrasive.